MedicineNet.com
About Us | Privacy Policy | Site Map
February 10, 2010
MedicineNet home Picture Slideshows Diseases and conditions Symptoms and signs Procedures and tests Medications Picture Image Collection MedTerms medical dictionary Pet Health
Font Size
A
A
A


Medications and Drugs

Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD

GENERIC NAME: isosorbide dinitrate

BRAND NAMES: Isordil Titradose, Dilatrate-SR, Isochron

DRUG CLASS AND MECHANISM: Isosorbide dinitrate is in the class of drugs called nitrates and it used for treating and preventing angina or heart pain. Other nitrates include nitroglycerin (Nitrostat, Nitroquick, Nitrolingual, Nitro-Dur and others) and isosorbide mononitrate (Imdur, Ismo, Monoket). Isosorbide dinitrate is converted in the body to isosorbide mononitrate which is the active chemical.

Nitrates are vasodilators (dilators of blood vessels). Blood returning from the body in the veins must be pumped by the heart through the lungs and into the body's arteries against the high pressure in the arteries. In order to accomplish this work, the heart's muscle must produce and use energy ("fuel"), and this requires oxygen. Angina pectoris (angina) or "heart pain" is due to an inadequate flow of blood (and oxygen) to the muscle of the heart. Nitrates, including isosorbide dinitrate, correct the imbalance between the flow of blood and oxygen to the heart and the work that the heart must do by dilating (expanding) the arteries and veins in the body. Dilation of the veins reduces the amount of blood that returns to the heart that must be pumped. Dilation of the arteries lowers the pressure in the arteries against which the heart must pump. As a consequence of both effects, the heart works less and requires less blood and oxygen.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets (sublingual): 2.5, 5, 10 mg. Tablets (immediate release): 5, 10, 20, 30, 40 mg. Tablets (extended release): 40 mg. Capsules (sustained release): 40 mg

STORAGE: Isosorbide dinitrate should be stored at room temperature, 15-30 C (59-86 F).

PRESCRIBED FOR: Isosorbide dinitrate is used for the treatment and prevention of angina caused by coronary artery disease. Only sublingual tablets are used for immediate treatment of angina because the onset of action of oral isosorbide dinitrate is not fast enough. Isosorbide dinitrate sometimes is used for treating congestive heart failure.

DOSING: Isosorbide dinitrate tablets can be taken with or without food. The sublingual tablets should be dissolved under the tongue and should not be crushed or chewed. Tolerance (reduced effect after several doses) may develop, so a drug free period of at least 14 hours is recommended. The recommended doses of isosorbide dinitrate are:

  • Tablets: 5-40 mg 2 or 3 times daily
  • Tablets: (sublingual): 2.5-10 mg
  • Tablets: (extended-release) and capsules (sustained-release): 40-80 mg once or twice daily.

DRUG INTERACTIONS: Sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra) increase the blood pressure lowering effects of isosorbide dinitrate and may cause excessive blood pressure reduction. Patients taking isosorbide dinitrate should not receive sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra). Severe blood pressure reduction, especially when changing posture, may occur when isosorbide dinitrate is combined with calcium channel blockers, for example, diltiazem (Cardizem, Tiazac, etc.) and verapamil (Calan, Verelan, etc.) which also reduce blood pressure.

PREGNANCY: There are no adequate studies of isosorbide dinitrate in pregnant women.

NURSING MOTHERS: It is not known if isosorbide dinitrate is excreted in human breast-milk.

SIDE EFFECTS: Headaches are the most common side effect and usually are dose-related (increase with higher doses). Flushing may occur because isosorbide dinitrate dilates blood vessels. Isosorbide dinitrate may cause a drop in blood pressure when rising from a sitting position (orthostatic hypotension), causing dizziness, palpitations, and weakness. To reduce the risk of these side effects, patients should rise slowly from a sitting position.

Reference: FDA Prescribing Information


Last Editorial Review: 2/20/2009




Report Problems to the Food and Drug Administration

 

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.


Printer-Friendly Format  |  Email to a Friend


Suggested Reading by Our Doctors
MedicineNet Doctors
  • Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
  • Congestive Heart Failure - Read about congestive heart failure symptoms like fatigue, abdomen, leg and ankle swelling, shortness of breath, sleeplessness, increased urination, nausea, abdominal pain, and decreased appetite.
  • Drugs: What You Should Know About Your Drugs - Find out what you should know about your drugs such as side effects, warnings and precautions, storage information, and if a generic version is as good as the brand name.

Latest Medical News


Back to Medications Index


Heart Health

Get the latest treatment options.


Are you Depressed? Take the Quiz

Your Guide to Symptoms & Signs: Pinpoint Your Pain



Related Drugs - WebMD Health Network

isosorbide dinitrate, Isordil Titradose, Dilatrate-SR, Isochron

What Is Heart Failure?

Heart failure does not mean the heart has stopped working. Rather, it means that the heart's pumping power is weaker than normal. With heart failure, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart respond by stretching to hold more blood to pump through the body or by becoming more stiff and thickened. This helps to keep the blood moving for a short while, but in time, the heart muscle walls weaken and are unable to pump as strongly. As a result, the kidneys often respond by causing the body to retain fluid (water) and sodium. If fluid builds up in the arms, legs, ankles, feet, lungs or other organs, the body becomes congested, and congestive heart failure is the term used to describe the condition.

What Causes Heart Failure?

Heart failure is caused b...

Read the Heart Failure article »











Health categories:

Slideshows | Diseases & Conditions | Symptoms & Signs | Procedures & Tests | Medications | Image Collection | Medical Dictionary | Pet Health

Popular health centers:

Allergies | Arthritis | Blood Pressure | Cancer | Chronic Pain | Cold & Flu | Diabetes | Digestion | Eyesight | Health & Living | Healthy Kids

Hearing & Ear | Heart | Infectious Disease | Men's Health | Mental Health | News & Views | Pregnancy | Sexual Health | Skin | Women's Health | More...

MedicineNet.com:

About Us | Newsletters | RSS Feeds | Privacy Policy | Site Map | WebMD® | Medscape® | eMedicine® | eMedicineHealth® | RxList®

This website is certified by Health On the Net Foundation. Click to verify. This site complies to the HONcode standard for trustworthy health information:
verify here.

©1996-2010 MedicineNet, Inc. All rights reserved. Notices and Legal Disclaimer.
MedicineNet does not provide medical advice, diagnosis or treatment. See additional information.